术前应用氟比洛芬对全凭静脉麻醉腹腔镜胆囊切除术患者的影响

The effect of flurbuprofen axetil on laparoscopic cholecystctomy

目的探讨术前应用氟比洛芬对全凭静脉麻醉腹腔镜胆囊切除术患者的影响。方法选取60例择期行腹腔镜胆囊切除术的患者，ASA（美国麻醉医师协会）Ⅰ-Ⅱ级，按数字随机法随机分为对照组（A组）30例和给药组（B组）30例。给药组在全身麻醉诱导前15min静脉给氟比洛芬酯注射液1mg／kg。观察两组患者麻醉诱导前，插管后即刻，切皮前5min（T0），切皮（T1），切皮后5min（T2），10min（T3），15min（T4），20min（T5），25min（T6）的血压，心率和BIS值。结果给药组与对照组在清醒和麻醉过程中的BIS值差异无统计学意义（P〉0．05），与对照组相比，给药组在T1时间点（即切皮时）的收缩压和舒张压均明显较低，两组差异无统计学意义（P〉0．05）。结论术前应用氟比洛芬酯对BIS值没有明显影响，不会改变全凭静脉麻醉下腹腔镜胆囊切除术中的镇静程度，但可以降低手术中伤害性刺激时的心血管反应，使血流动力学更平稳。

Objective To evaluate whether administration of Flurbiprofen Axetil before elective laparoseopic eholeeysteetomy can affect the BIS index and hemodynamics. Method Sixty patients scheduled for elective laparoscopie eholecysteetomy were randomized into two groups. Flurbiprofen axetil 1 mg/kg was used intravenous 15 minutes before induction of general anesthesia in group B, while group A without premeditation. Total intravenous anesthesia was maintained with propofol TCI. BIS index, bloodpressure and heartrate were recorded at the time just before induction, after endotracheal intubation, 5 minutes before incision, incision, 5, 10 , 15, 20 and 25 rains after incision. Result There were no significant difference between two groups in BIS index during period of anesthesia and awakeness （ all P 〉 0. 05 ）. Compared with group A, both systolic and diastolic blood pressure in group B at time of incision（ T1 ） are apparently lower （ P 〈 0. 05 ）. While, blood pressures were no significant different at other time （ all P 〉 0. 05）. Condusion In this study, administration of flurbiprofen before surgery of laparoseopie cholecystectomy did not alter BIS and the degree of sedation during total intravenous anesthesia. But it can reduce the harmful stimulation to cardiovascular reaction from surgery and make hemodynamie status more stable. Flurbiprofen can be safely and effectively used on elective laparoscopic cholecystectomy.